玻璃体切割眼内光凝硅油充填治疗急性视网膜坏死综合征

The effect of vitrectomy,endolaser photocoagulation and silicone oil injection for acute retinal necrosis syndrome

目的:急性视网膜坏死综合征(ARNS)致盲率高,及时行玻璃体切割、眼内光凝和硅油充填术是挽救患者残余视力的重要方法。探讨ARNS行玻璃体切割眼内光凝硅油充填手术治疗后的效果。方法:对16例(16只眼)ANRS患者行玻璃体切割眼内光凝硅油充填手术,切除全部玻璃体。其中5例(31.3%)无视网膜脱离者由坏死区后缘光凝到锯齿缘,11例(68.7%)有视网膜脱离者行次全视网膜光凝、气/液交换后行硅油充填。所有患者术后至少随访半年,平均16个月。结果:最佳矫正视力有3例(18.8%)为指数,7例(43.8%)为0.02～0.3,5例(31.3%)为0.4～0.6,1例(6.3%)为0.7。其中14例(87.5%)术后3～12个月顺利取出硅油,视网膜保持复位。结论:玻璃体切割眼内光凝硅油充填手术是治疗ANRS的重要方法。

Objective：Acute retinal necrosis syndrome（ARNS） is a rare disease with high blinding rate. The surgery of vitrectomy, endolaser photoeoagulation and silicone oil injection is considered an effective treatment of ARNS. The study investigated the effect of vitrectomy, endolaser photocoagulation and silicone oil injection treating ARNS. Methods：A consecutive 16 eyes of 16 patients with ARNS were treated with vitrectomy, endolaser photocoagulation and silicone oil injection. The 5 eyes without retinal detachment were photocoagulated from the posterior border of necrosis to the ora serrata. The 11 eyes with retinal detachment were treated with subtotal retinal photocoagulation, air/fluid exchange and silicone oil injection. The follow-up time were 6 months at least, 16 months in average. Results：The final best-correcting visual acuity was counting fingers in 3 eyes（ 18.8% ）, 0. 02-0.3 in 7 eyes（43.8% ）, 0.4-0.6 in 5 eyes（31.3%）, 0.7 in l eye（6.3%）. The silicone oil was uneventfully removed in 14 patients （87.5 %） from 3 to 12 months. No one had a recurrent retinal detachment. Conclusion：There is a favorable effect in ARNS with the treatment of vitrectomy, endolaser photocoagulation and silicone oil injection.